High immature platelet fraction with reduced platelet count on hospital admission. Can be useful for Covid-19 diagnosis?

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High immature platelet fraction with reduced platelet count on hospital admission. Can be useful for Covid-19 diagnosis?

Short running title: Platelet parameters and Covid-19

Giovanni Introcaso, Alice Bonomi, Laura Salvini, Tiziana D’Errico, Annalisa Cattaneo, Emilio Assanelli, Silvia Stella Barbieri, Maria Luisa Biondi

GI, TD, AC, MLB, Unit of Laboratory Medicine – Centro Cardiologico IRCCS Monzino – Milan Italy

AB, Unit of Biostatistics– Centro Cardiologico IRCCS Monzino – Milan Italy

LS, EA, Emergency Department– Centro Cardiologico IRCCS Monzino – Milan Italy

SSB, Unit of Brain-Heart Axis - Centro Cardiologico IRCCS Monzino – Milan Italy

Corresponding author: Giovanni Introcaso, Unit of Laboratory Medicine, Centro Cardiologico IRCCS Monzino – Milan Italy

Via Parea , 20138 Milano, phone: 0039/0258002595

e-mail: giovanni.introcaso@ccfm.it

Keywords: Platelet parameters, H-IPF, Covid-19, Hematological biomarkers, Emergency Department

ABSTRACT

Introduction: Health professions are heavily engaged facing the current threat of Sars Cov-2 (Covid-19). Although there are many diagnostic tools, an accurate and rapid laboratory procedure for diagnosing Covid-19 is recommended. We focused on platelet parameters as additional biomarkers for clinical diagnosis in patients presenting to the emergency department (ED).

Materials and Methods: 561 patients from February to April, 2020 have been recruited. Patients were divided into three groups: (N=50) Covid-19 positive and (N= 21) Covid-19 negative with molecular testing, (N=490) as reference population without molecular testing. A Multiplex rRT-PCR from samples collected by nasopharyngeal swabs was performed and the hematological data collected.

Results: We detected a mild anemia in Covid-19 group and lymphopenia against reference population: hemoglobin (g/dL) 13.0 (11.5-14.8) vs 13.9 (12.8-15.0) (p=0.0135); lymphocytes (10⁹/L) 1.24 (0.94-1.73) vs 1.99 (1.49-2.64) (p<0.0001). In addition, abnormal platelet parameters as follows (Covid group versus reference population): PLT (x10⁹/L) 209(160-258) vs 236(193-279) (p=0.0239). IPF (%) 4.05 (2.5-5.9) vs 3.4 (2.2-4.9) (p=0.0576); H-IPF (%) 1.25 (0.8-2.2) vs 0.95 (0.6-1.5) (p=0.0171) were identified. In particular, Covid positive group had a high H-IPF/IPF Ratio compared to reference population [0.32 (0.29-0.36) vs 0.29 (0.26-0.32), respectively, (p=0.0003)]. Finally, a PLT difference of nearly 50x10⁹/L between pre/post Covid-19 sampling for each patient was found (N=42) (p=0.0194). Conclusions: Covid-19 group results highlighted higher IPF and H-IPF values, with increased H-IPF/IPF Ratio, associated to PLT count reduction. These findings shall be adopted for a timely diagnosis of patients upon hospital admission.